Healthcare Provider Details

I. General information

NPI: 1144201591
Provider Name (Legal Business Name): NORTH HILL LABORATORY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N 6TH ST
BURLINGTON IA
52601-4920
US

IV. Provider business mailing address

825 N 6TH ST
BURLINGTON IA
52601-4920
US

V. Phone/Fax

Practice location:
  • Phone: 319-752-8422
  • Fax: 319-752-4860
Mailing address:
  • Phone: 319-752-8422
  • Fax: 319-752-4860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number1601011985
License Number StateIA

VIII. Authorized Official

Name: MR. ROGER ALAN NEVLING
Title or Position: OWNER
Credential: PA C
Phone: 319-754-1555